Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

I. Guttmann-Bauman, P. Thornton, S. Adhikari, K. Reifschneider, M. A. Wood, T. Hamby, K. Rubin

Research output: Contribution to journalArticle

Abstract

Background: The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. Methods: The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Results: Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Conclusions: Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system.

Original languageEnglish (US)
Pages (from-to)859-865
Number of pages7
JournalPediatric Diabetes
Volume19
Issue number5
DOIs
StatePublished - Aug 2018

Keywords

  • care delivery
  • diabetes practice
  • population health

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

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    Guttmann-Bauman, I., Thornton, P., Adhikari, S., Reifschneider, K., Wood, M. A., Hamby, T., & Rubin, K. (2018). Pediatric endocrine society survey of diabetes practices in the United States: What is the current state? Pediatric Diabetes, 19(5), 859-865. https://doi.org/10.1111/pedi.12677